Infectious Disease Book

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Extended Spectrum PenicillinAka: Ticarcillin, Piperacillin, Carbenicillin, Timentin

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  1. See Also
    1. Penicillin
  2. Indications
    1. Serious Gram Negative Bacterial infection
    2. Use alone or in combination with Aminoglycosides
  3. Preparations
    1. Alpha carboxy Penicillin
      1. Carbenicillin
      2. Ticarcillin (Ticar)
      3. Ticarcillin clavulanate (Timentin)
    2. Acylamino-Penicillin
      1. Mezlocillin (Mezlin)
      2. Piperacillin (Pipracil)
      3. Piperacillin tazobactam (Zosyn)
  4. Mechanism of action
    1. Similar to Natural Penicillins
    2. Greater penetration through Gram Negative membrane
    3. High affinity for Penicillin binding proteins
    4. Beta lactamase resistance with Clavulanate, Tazobactam
  5. Bacterial Resistance
    1. Beta lactamase (except with Clavulanate or Tazobactam)
    2. Alteration of Penicillin binding proteins (Pseudomonas)
  6. Dosing: Parenteral
    1. Ticarcillin Clavulanate (Timentin)
      1. Adult: 3.1 g IV q4-6h
      2. Child: 50 mg/kg up to 3.1 g IV q4-6 hours
    2. Piperacillin Tazobactam (Zosyn)
      1. Adult: 3.375 g IV q6 hours
  7. Adverse Effects
    1. Many side effects in addition to Natural Penicillins
    2. High sodium load (Carbenicillin)
    3. Platelet Dysfunction
  8. Activity Spectrum
    1. Similar to Natural Penicillins and Aminopenicillins
    2. Expanded Gram Negative coverage
      1. Escherichia coli
      2. Morganella
      3. Proteus
      4. Providencia
      5. Salmonella
      6. Shigella
      7. Pseudomonas

Carbenicillin (C0006976)

Definition (MSH)Broad-spectrum semisynthetic penicillin derivative used parenterally. It is susceptible to gastric juice and penicillinase and may damage platelet function.
Definition (NCI)A broad-spectrum, semi-synthetic carboxypenicillin antibiotic with bactericidal activity. Carbenicillin acylates C-terminal domain of penicillin-sensitive transpeptidase, resulting in opening the lactam ring of the antibiotic. This inactivation prevents the formation of the cross-linkage of peptidoglycan strands, thereby inhibiting the third and last stage of bacterial cell wall synthesis. As a result, cell wall integrity is compromised and cell lysis may follow. This agent is used mainly for gram-negative infections, and has limited gram-positive coverage.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishCarbenicillin, CARBENICILLIN PREPARATION, Carboxybenzyl Penicillin
Spanishcarbenicilina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Piperacillin (C0031955)

Definition (MSH)Semisynthetic, broad-spectrum, AMPICILLIN derived ureidopenicillin antibiotic proposed for PSEUDOMONAS infections. It is also used in combination with other antibiotics.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishPiperacillin, PIPERACILLIN PREPARATION, Pipercillin
Spanishpiperacilina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Ticarcillin (C0040193)

Definition (MSH)An antibiotic derived from penicillin similar to CARBENICILLIN in action.
Definition (NCI)A broad-spectrum, semi-synthetic Penicillin antibiotic with bactericidal activity. Similar to carbenicillin in action, ticarcillin acylates C-terminal domain of penicillin-sensitive transpeptidase, resulting in opening the lactam ring of the antibiotic. This inactivation prevents the formation of the cross-linkage of peptidoglycan strands, thereby inhibiting the third and last stage of bacterial cell wall synthesis. As a result, cell wall integrity is compromised and cell lysis may follow. This agent usually is administered with a beta-lactamase inhibitor such as clavulanic acid.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishTicarcillin, TICARCILLIN PREPARATION
Spanishticarcilina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Timentin (C0076686)

ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishTimentin
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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